What I talk about in my teaching sessions

Parkinson

Starting with a patient with “bent spine syndrome” aka camptocormia we go through the fascinating duality

peripheral (myogenic) causes

central (mostly degenerative) causes

Of course, the most important diagnosis is Parkinson’s (where camptocormia tends to appear later rather than earlier), but other classical neurodegenerative diseases such as MSA-P, PSP may also cause camptocormia.

Even more interesting is what happens in PD with camptocormia. It is really unclear how myopathic and myositic findings can occur (such as elevated CK, myodegeneration in MRI, myopathic EMG, inflammatory changes on muscle biopsy of the erector spinae) in a disease that we all believe happens in the CNS…

As for treatment, you can try

change from dopamine agonists to L-Dopa (or vice versa)

BoTox of the abdominal muscles

steroids or IVIGs (if a lot of inflammation can be seen on MRI or biopsy)